Role concepts and expectations of physicians and nurses in hospitals.

The social environment in which hospitals in the Netherlands have to function nowadays is greatly changing. Over the last 10 years the policy of the Dutch government has become less directive, market mechanisms are gaining weight and the demand for services by patients is changing. As a result of these changes hospitals formulate their strategic goals in terms of improvement of quality of care and efficacy. A basic assumption in this article is that quality of care is to be gained by collaborative practice between physicians and nurses. A necessary condition for this is that there is a correspondence in role concepts and expectancies of physicians and nurses in hospitals. The object of this research is to describe the role concepts and role expectations of nurses, physicians and patients in two Dutch hospitals. In general, the research revealed considerable differences between role behaviour and role concepts among nurses. In the long run these differences may not be favourable for good understanding between them and physicians, or for their own job satisfaction. This may also have negative consequences for collaboration between nurses and physicians and, finally, for the quality of care and cure within the ward. There is a need for discussion of the role concepts of nurses in relation to their actual regular tasks in order to resolve this. A second discrepancy exists between the role behaviour of physicians and the expectations of nurses about this behaviour. This may also lead to a lower job satisfaction for nurses. Taking into account the fact that patients are satisfied with the way physicians and nurses pay attention to most aspects of care and cure, a discussion between physicians and nurses could be recommended. The aim is revising either the role behaviour of physicians, especially as regards their attention to the psycho-social needs of patients, or the expectations of nurses, or both.